SUBMISSION
for the
OIREACHTAS COMMITTEE ON FUTURE OF
HEALTHCARE
IRELAND EAST HOSPITAL GROUP
NOVEMBER 2016
Contents
Executive Summary ................................................................................................................................................ 3
Introduction ............................................................................................................................................................. 4
Ireland East Hospital Group .................................................................................................................................... 5
Key facts ............................................................................................................................................................. 5
IEHG: Structure, Governance and Relationships ............................................................................................... 5
IEHG Mission and Goals .................................................................................................................................... 7
Group Core Ambitions ........................................................................................................................................ 8
IEHG Framework Programme................................................................................................................................. 9
Unscheduled Care ............................................................................................................................................ 10
Unscheduled Care Service Improvement Programme ..................................................................................... 10
Clinical Integration with the Community ............................................................................................................ 11
Primary Care Integration................................................................................................................................... 11
Scheduled Care ................................................................................................................................................ 12
Quality and Patient Safety ................................................................................................................................ 12
Clinical Redesign and Integration ..................................................................................................................... 13
Women and Infant’s Health .............................................................................................................................. 14
Academic Partner: UCD ........................................................................................................................................ 15
Clinical Academic Directorates & Clinical Directorates ..................................................................................... 15
Health Informatics / Digital Health .................................................................................................................... 15
Genetics / Genomics ........................................................................................................................................ 16
Human Imaging ................................................................................................................................................ 16
Education and Training ..................................................................................................................................... 16
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Executive Summary
The establishment of hospital Groups provides a unique opportunity to deliver integrated models of care, and to
bring research and innovation to the core of the clinical service delivery model.
The Ireland East Hospital Group (IEHG) was established in January 2015 and is the largest and most complex of
the hospital groups. Comprising 11 hospitals (6 voluntary and 5 statutory), IEHG spans eight counties and four
Community Health Organisations (CHOs), and has a gross annual expenditure of in excess of €1billion.
IEHG’s ambition is “to be the national leader in healthcare delivery, with a strong international reputation,
improving the quality of healthcare and better patient outcomes through education, training, research and
innovation for the 1.1million people we serve”. To achieve this ambition we have developed a ten-point
framework programme, which will see IEHG established as an independent hospital group, with an Academic
Health Sciences Centre as its core.
Over the past two years IEHG has
 Established a management team to run the largest hospital group;
 Prioritised developing integrated pathways across the continuum of care between the acute, primary,
community and continuing care services;
 Focused on developing a robust quality and patient safety function, to ensure that high quality safe care
is delivered;
 Developed our first Clinical Academic Directorate in cancer, as a move towards an Academic Health
Sciences approach;
 Introduced an unscheduled care transformation programme to improve patient throughput in our EDs
and enhance patient experience;
 Created additional surgical and outpatient capacity in the group, by ensuring that model 2 hospitals
carry out higher volumes of low acuity work, thereby freeing up capacity in the model 4 hospitals.
We now want to build on the positive start, and make meaningful changes to the delivery of care, so that every
patient within the IEHG can receive the same access to high quality, safe care, regardless of where they live. To
further develop and fulfil our ambition we need to have primary legislation, which will enable IEHG to become an
independent hospital group, with its own Board, operating under the HSE’s commissioning arm, and with fully
accountability to the Oireachtas. Hospital Groups, if properly constituted will enable the acute hospital sector to
 Integrate with the primary continuing and community care sector in a manner not previously achieved;
 Bring research and innovation to the core of service delivery, ensuring that bench to bedside
developments become a reality;
 Ensure that we can meet the needs of the local population within a quality and safety framework that
delivers high quality safe care;
 Develop operating models that ensure smaller hospitals are aligned with academic teaching hospitals,
thereby improving the quality of care to all our patients;
 Provide patients with the same access to quality care regardless of location;
 Optimise the use of resources, by ensuring that care is delivered in the most appropriate location.
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Introduction
The Ireland East Hospital Group is Ireland’s largest hospital network with a unique profile of local services and
focused tertiary specialties, across eight counties and serving a population of 1.1million people. The group
provides a wide range of acute and elective inpatient and outpatient services across 11 hospital sites and
provides services on three levels; those serving local catchment areas, specialist services delivered to regional
populations and quaternary services delivered nationally.
The 11 Hospitals include
Level 4
 Mater Misericordiae University Hospital
 St Vincent’s University Hospital
Level 3
 Our Lady’s Hospital, Navan
 Regional Hospital, Mullingar
 St Luke’s General Hospital, Kilkenny
 Wexford General Hospital
Level 2
 St Columcille’s Hospital
 St Michael’s Hospital, Dun Laoghaire
Speciality Hospitals
 Cappagh National Orthopaedic Hospital
 National Maternity Hospital, Holles Street
 Royal Victoria Eye & Ear Hospital
Our hospitals are among the best in Ireland for quality of care, safety and clinical performance medical education
and healthcare research. The Group includes voluntary, independent and HSE hospitals providing a wide variety
of specialities on a national, regional or local level, to different patient categories. The new group structure
facilitates collaboration and works closely together to allow integration and improved patient flow across the
continuum of care. This enables our Hospitals within the group to deliver high quality, safe patient care in the
most cost effective manner.
A core objective of the IEHG is to develop an Academic Health Sciences Centre, where education and research
contribute to patient care and wellbeing. Internationally, such centres have scored well ahead of non-academic
centres for patient outcomes and safety. AHSCs attract leading healthcare professionals and offer excellent
training, adopt new technologies and health systems improvements rapidly, and participate in a global effort to
advance healthcare. This is elaborated upon further in the submission. The IEHG builds on the Dublin Academic
Medical Centre, an incorporated not-for-profit partnership established in 2007 between UCD and its two affiliated
university hospitals, MMUH and SVUH, placing the DAMC at the heart of its Hospital Groups and associated
Community Health Organisations.
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Ireland East Hospital Group
Key facts
Largest of the Hospital Groups with
UCD as the academic partner
11 hospitals, 6 of which are voluntary
Works with 4 Community
Health Organisations
Gross spend of in excess of €1 billion
Serving a population of 1.1m people
with 10,800 staff
Strong engagement with
primary, community and
continuing care
Largest number of National Specialist Services which include the National Heart/Lung /Liver/Pancreas
Transplant Units ,National Spinal Unit, National Isolation Unit for Infectious Diseases, National Unit for Cystic
Fibrosis, National Unit for Pulmonary Hypertension, National Unit for Neuroendocrine Tumours, National Extra
Corporeal Life Support , Cardiothoracic Surgery,
The Cancer Academic Directorate is the largest cancer service in the country which provides







Over 45% of patients treated for breast cancer in Ireland
Almost 1:4 of all prostate cancers
Over 50% of all breast cancer screening through Breast Check on the two hospitals sites
National centre for hepatobiliary cancer surgery
National Centres for Sarcomas and Neuroendocrine tumours
National Centre for Spinal surgery for advanced treatment of metastatic tumours
The only centre providing cytoreductive surgery and heated intra-peritoneal chemotherapy for advanced
abdominal malignancy.
IEHG: Structure, Governance and Relationships
IEHG consists of six voluntary hospitals and five statutory (HSE) hospitals. The six voluntary hospitals are funded
by the HSE under Section 38 agencies under 2004 Health Act). Three voluntary hospitals (NMH, RVEEH and
CNOH) are constituted by legislation or charter (where established prior to 1922). MMUH and SVHG (the legal
entity holding SVUH, SMH and its private hospital) are companies incorporated under the Companies Act 2014
and are also registered charities. This presents some unique challenges to our group as each of these entities
have their own corporate governance arrangements, and legal obligations.
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The Hospital Groups have been established on an administrative basis using existing legalisation, principally the
Health Act 2004. The Chairs were appointed by the Minister of Health in 2013 and executive authority is vested
in the Group Chief Executive by a delegation order from the Health Service Executive’s National Director of
Acute Hospitals. The current arrangement gives rise to a number of challenges, primarily around accountability
and governance, and primary legislation is urgently required to mitigate these risks. The CEO would then be
accountable to a Board, appointed in line with best practice through the Public Appointments Service, which
would in turn be accountable to the Minister for Health and the Health Service Executive as commissioner. This
will provide clear lines of accountability for patient safety and quality as well as direct line of accountability to the
Oireachtas for funding.
The acute hospital system in Ireland incorporates publicly owned and operated hospitals as well as voluntary
hospitals (more accurately defined as independent public hospitals). However most voluntary hospitals are in
practice state owned hospitals (St. James’s Hospital, Tallaght, Beaumont) or hospitals formed by charter,
principally the Dublin Maternity Hospitals and a number of small voluntary hospitals. There are six voluntary
hospitals; two of which are within the Ireland East Hospital Group, the Mater and St. Vincent’s, which do not have
a legal nexus with the state other than through a section 38 of the Health Act 2004. While diversity of provision
has been a very positive feature of hospital service delivery in Ireland and has made an important contribution to
healthcare in Ireland, it creates significant governance challenges to designing and implementing national or
regional (Group) approaches to the design and delivery of care.
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IEHG Mission and Goals
The Ireland East Hospital Group, with University College Dublin, will be the national leader in health care
delivery, with a strong international reputation, improving the quality of healthcare and better patient outcomes
through education, training, research & innovation for the 1.1 million people we serve.
Our mission is to deliver improved healthcare outcomes for the 1.1 million
people we serve
Goals
Develop a best in class quality and safety culture
around patients and associated services across the
Group
Create and develop an IEHG/new Trust affiliation with
UCD at a comprehensive level and as the leading Irish
Academic Health Science Centre (AHSC) partnership
with international peer status and association
Transform, re-organise, rationalise, expand, develop and
integrate clinical services across the Group to meet
community and population needs and expectations at
catchment, regional, supra regional and national levels
Transform IEHG into the largest and most
comprehensive independent Hospital Trust in Ireland
Develop a best-in-class talent workforce
which is engaged and committed and
continuously challenges and drives Group and
system functioning
Rationalise and develop physical infrastructure across
the Group/new Trust to fit-for-purpose/contemporary
model reflective of an AHSC of highest international
peer status
Specify the key tertiary/quaternary services to apply at
IEHG/new Trust and develop them to best-in class
international peer status
Develop the Group/new Trust as the most
technologically advanced entity in the Irish health
system to comparable best in-class international peer
status
Integrate with our CHO partners and further develop GP integration with our hospitals. The formation of IEHG
enables the coalescence of a broad range of clinical services across 11 hospitals combined with the
cutting edge research and academia of University College Dublin (UCD)
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The Group has developed a corporate plan which presents the operational priorities for the Group over the next
three years (2016 -2018) and each priority is aligned to our framework programme. This plan demonstrates how
the Group will develop from a disparate group of 11 hospitals and university partner into an integrated Academic
Health Sciences Centre. The Group also has a strategic plan in development.
Group Core Ambitions
Working with UCD and the HSE, IEHG will seek to consolidate our internal group relationships; strengthen and
elevate our group identity; increase adoption of research-based policies and practices; promote scientific
discoveries and strengthen research collaboration to become the national leader in healthcare delivery.
Quality / Safety
Consistent high
quality, safe care
across 11
hospitals putting
the patient at the
core of everything
we do
Clinical
Excellence
Not the right
header
Optimise the
IEHG position of
having the
greatest number
of specialities and
the most complex
range of services
available to
patients
Transformation
Information
Integration
Work with UCD to
create an
Academic Health
Sciences Centre
to transform
healthcare
through innovative
education,
training, research
and innovation
Harness data
analytics and
communications
to optimise the
use of information
and realise the
value of patient
data in making
evidence based
decisions
Transform and
integrate clinical
services across
the 11 hospitals to
meet the needs of
the people we
serve
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IEHG Framework Programme
Development of IEHG to a state of readiness for its establishment as Hospital Group under primary legalisation
and this is being pursued under the aegis of a comprehensive ten-point Framework Programme. The
programmes within the framework include
Communications
10
Innovation and
entrepreneurship
1
Constitution of IEHG
Governance
9
Creating conditions
for board
status
2
Influencing and
positioning
8
IEHG
Framework
Programme
3
National / international
associations
7
Shared / single
corporate functions
and support services
4
Integration with primary,
community, continuing and home
care entities
6
5
Creation of IEHG Quality,
Safety & Risk
Management function
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Clinical services design
and re-organisation
Unscheduled Care
IEHG, in line with National trends, has experienced increased demand in our six hospitals with Emergency
Departments (EDs) and increased demand for inpatient bed capacity. That increase is predicted to continue with
ED attendances in some hospitals expected to reach the highest on record this year. Acute hospital analysis
reflects the impact of the increases in the older age groups within our population, and the data demonstrates that
older patients are requiring longer acute hospital stays and have more complex needs.
Emergency presentations, at 137,235 in IEHG during winter 2015/2016 were up by 4% on the previous winter.
2016 activity to date suggests that this trend will continue with a conservative estimate being a further 4%
increase.
National research and recent trends demonstrate that1
 In 2017 we can expect a projected increase of 34,800 persons in our population with an additional
19,800 aged 65 years and over and 2,600 aged 85 years and over.
 In 2017 it is projected that there will be an overall increase in adult in-patient discharges of 11,900
from 2015. This equates to approximately 344 additional adult hospital in-patient beds at 100%
utilisation of seven day beds.
 In 2017, if ED attendance rates remain constant, it is projected that ED attendances will increase by
over 3,200 for those aged 85 and over and by 11,581 for those aged 65-84
 Patients over 85 will have an average length of stay more than double that of someone under 65
(greater than 12 days, versus 6 days)
IEHG believe that long term changes to how health services are delivered will positively impact the delivery of
acute hospital services and are working with our community partners through our strategy and framework
programme to integrate services in line with national strategic priorities, e.g. integrated frail elderly pathways,
GP/MAU pathways etc.
Unscheduled Care Service Improvement Programme
IEHG is committed to improving the quality of service delivery. To support this, we have embarked on a
challenging Unscheduled Care Service Improvement Programme. The main goal of this programme is to improve
the safety and experience for all patients and staff in the unscheduled care pathway. The group recognises that
in a climate of increasing ED attendances and acute hospital activity, that consistently achieving performance
targets is increasingly challenging. Therefore, we are initiating this evidence-based lean process improvement
programme to proactively address this challenge. Through staff engagement and using lean methodology we
aim to achieve process and quality improvements resulting in organisational and cultural change.
This programme, which will run over the next 3 years, has commenced in two IEHG hospitals to date and will
expand to all our acute hospitals during winter 2016/2017 through a series of Rapid Improvement Events (RIEs).
Dedicated Service Improvement Leads for Process improvement will support hospital sites and drive quality,
1
Planning for Health Trends and Priorities to inform Health Service Planning 2017
Page | 10
safety and positive improvement to unscheduled care. This change methodology will support and embed a
cultural change amongst staff and has been supported by the HSE Programme for Health Service Improvement,
High level performance measures for the programme will focus on Governance, Patient Safety, Patient
experience, Resource Efficiency and outcomes.
In parallel IEHG has implemented a dedicated dashboard to measure unscheduled care performance
Clinical Integration with the Community
Patients access care based on their needs, and it is important that the movement between different types of care
provision – acute, primary, continuing and community is integrated around the needs of the patient. IEHG has a
dedicated work programme on Integration with Primary, Community, Continuing and Home Care Entities with a
primary objective of aligning the needs of patients across the continuum of care and the acute hospitals within
IEHG.
The group has focused on clinical pathways, rather than reviewing the interaction through the social care, mental
health and primary care lens. It was agreed that the management of frail elderly patients was a shared goal
across all aspects of the health system. Therefore the key focus of the work programme is on accessing
existing patient pathways in a new way, or creating pathways that do not currently exist. Initiatives that have
been developed are reablement model of care, community geriatrician programme, improve pathway from
nursing homes to acute medical assessment unit, standardise referral documentation and rapid response team
in the Emergency Department to manage the frail elderly pathway. These initiatives will be evaluated to assess
their effectiveness in managing the frail elderly in the most appropriate location.
Primary Care Integration
IEHG has prioritised improvement in links with Primary Care and specifically to improve links between GPs and
their local hospitals. A GP advisory group has been established and endorsed the concept of Local Integrated
Care Committees (LICCs) which have been established to improved links between the hospital, community and
primary care sectors. Building on the successful GP liaison process in Carlow/Kilkenny these committees have
already been established in Kilkenny, Wexford, Mullingar, Loughlinstown – work is underway to progress the
LICC in Navan. The purpose of these committees is to focus on the pathways of care for patients, and to resolve
impediments to access at a local level. This model was integral to the opening of the new ambulatory day care
centre in St Luke’s in Kilkenny; is central to the redefinition of the range of services in St Columcille’s Hospital in
Loughlinstown, including direct access from continuing care settings to the acute medical unit; the development
of geriatrician outreach programme in Mullingar; the planned development of a musculoskeletal physiotherapist
led programme, based in the community, to remove patients from the Wexford ED; and will be central to the
development work planned for Our Lady’s Hospital Navan.
Agreement has recently been reached with the HSE Primary Care Division to roll the LICC model out nationally.
The national rollout will be led by the IEGH Primary Care executive lead (Dr Ronan Fawsitt).
IEHG is also exploring options for primary care collaboration in a variety of settings and the Group has already
introduced a number of initiatives which are designed to promote engagement of GPs with the reconfiguration of
Page | 11
local hospital services (work is underway to trial a GP post based between Navan and the Community) as part of
the wider realignment of services across the IEHG. These initiatives will focus on hospital avoidance initiatives
for high risk frail elderly.
In January of this year, UCD introduced clinical placements in GP practices for 126 students in their first clinical
year. Student experience was extremely positive and this will be repeated with the aim of expanding the role of
general practice in the curriculum.
IEHG has also launched Hepcare Europe a collaborative project led by Infectious Diseases at MMUH (and
shortly to commence in SVUH) which will provide treatment for patients with hepatitis C in the community - this is
a service which has traditionally been provided only in acute settings and will enable those who are ‘hard to
reach’ to access new life saving anti-viral therapies. The project has recently been awarded €1.8M in funding by
the EU and in that regard, is an illustration of how care is integrated across the community within the Group.
Scheduled Care
The Formation of the Hospital Groups can play a key role in supporting each other in enabling a network
approach to deliver patient care in the most appropriate setting; in terms of the IEHG this is the level 3 and level
2 Hospitals undertaking less complex work and enabling the level 4 hospitals to deliver speciality services.
In Navan for instance surgeons from the Mater have provided surgery on less complex patients freeing up much
valuable theatre capacity in the Mater. This also works effectively in St. Columcille’s and St Michael’s providing
support to St Vincent’s.
We also have joint appointments in Mullingar, Wexford and Kilkenny. In Wexford we have appointed a urologist,
who will also have sessions in SVUH. This will provide GPs with access to a local outpatient service, and where
patients need surgery, that surgery will happen in SVUH. Similarly in St Luke’s in Kilkenny we have appointed a
dermatologist, jointly with SVUH. This provides local outpatient access, and a referral to a tertiary centre if
required.
Quality and Patient Safety
IEHG has developed a Quality, Risk and patient Safety Directorate which is focused on five key areas
Clinical Risk
Management
Clinical
Indicators and
Performance
Metrics
Development of
a Quality
Institute
Innovation and
Lean
Transformation
Patients
Engagement
Strategy
The priority for IEHG is the further development of a risk management system which is comprehensive and
cohesive and incorporates both clinical and non-clinical risks. It will integrate incidents, complaints, risk registers,
credentialing, claims and recommendations. It will be underpinned by clear accountability arrangements.
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The Mater Hospital introduced in 2015, in partnership with the HSE, a quality improvement project named a
“Board on Board with Quality of Clinical Care”. The aim of this programme was to enhancing enhance the role of
the Board in overseeing and contributing to the improvement of the Quality of Care provided at the clinical
frontline. There is significant compelling evidence to suggest that Boards must have capable and committed
leadership at both executive and board levels to perform their role effectively. The project was the first of its kind
in Ireland and is very timely in light of the emerging new governance structures. The IEHG will be adopting this
approach in the development of the IEHG Board.
A key element of the quality framework for our group is to conduct a safety survey which will enable us to
comprehensively asses practice and processes behind the number.
Clinical Redesign and Integration
The IEHG has commenced the development of an extensive clinical service portfolio, which includes a capacity/
demand profile for the group under the specialities of care. The key focus of this work is governed by the
underlying principles
 Provide for a Clinical Services portfolio which meets the needs of the 1.1 million people we serve
 Ensure that the Group is fully self-sufficient with respect to hospital based services for its catchment
area.
 Implement systems to assure quality and efficiency in Clinical Services provided by the Group.
 Provide the acute hospital services in each location that meet the local population need, and
ensure high quality safe care
 Provide for creation of an Organisation Structure and process for Clinical Services which is
decentralised, flat and allows decision to be made as close as possible to the patient.
 IEHG’s approach to clinical redesign and integration will align with Government policy, and the
HSE’s existing Clinical Strategy and Programmes approach
Clinical integration between Model 3 and Model 4 hospitals is also underway. The appointment of new consultant
posts (e.g. in dermatology and urology) and the establishment of new pathways will improve access for patients
to care, and will ensure that that care takes place in the most appropriate location. The full implementation of this
goal will necessitate discussion with other hospital groups to realign clinical pathways to reflect new hospital
groupings. IEHG is keen to increase the number of these joint appointments which will reduce the demands on
Model 4 hospitals, and improve access for patients to speciality services at the large regional hospitals. . This is
key to optimising resource management across the Group and improving care options and local access for
patients.
Within the model 3 hospitals (Wexford, Kilkenny and Mullingar) we are introducing a common management
structure, based on the clinical directorate model, to ensure common patient pathways. A central theme of this
work is developing a workforce plan for each model 3 hospital, based on patient demand and the range of
services. This workforce plan will be completed in Q1 2017.
IEHG has also established a number of working groups in radiology and laboratory services. The laboratory
group is working towards the implementation of the Laboratory Modernisation Programme and the establishment
of two hub laboratories. The radiology group are reviewing capacity and access across the Group and are
developing common imaging protocols and support for delivery of cross site reporting.
Page | 13
IEHG has also established a number of specialist specific clinical groups to advise, plan and oversee delivery of
services in a number of services such as critical care, obstetrics ophthalmology and orthopaedics.
Women and Infant’s Health
IEHG has four hospitals with maternity services: the National Maternity Hospital (NMH) in Holles Street, which
has the largest number of births in the country: Mullingar Regional Hospital; St Luke’s Hospital Kilkenny and
Wexford General.
The establishment of IEHG has provided us with the opportunity to align the four maternity units, and share
learning across the four hospitals. The Master in the NMH established an obstetrics governance group in late
2015. This forum brings consultants, midwives and managers together and shares learning, as well as
developing quality metrics for the maternity services and doing drills and skills training. While NMH does not
have clinical governance for the obstetric services in the other hospitals within the Group, it does provide much
needed support and advice.
The obstetrics group within IEHG was established in advance of the managed clinical maternity networks,
recommended in the National Maternity Strategy. IEHG will implement this recommendation, with the
establishment of a Clinical Maternity Network, and the appointment of a Clinical and Director of Midwifery in line
with the HSE’s National Women and Infants’ Health Programme
Page | 14
Academic Partner: UCD
Clinical Academic Directorates & Clinical Directorates
IEHG clinical services will be managed and delivered through directorates, which will be either Clinical Academic
Directorates (CAD’s) or Clinical Directorates. The development of Clinical Academic Directorates is an exciting
development in building the Academic Health Sciences model of service delivery. The Clinical Academic
Directorates will be established as joint hospital group-university programmes that span clinical and academic
functions under the direction of a single Director with overall responsibility for the area. Recruitment, particularly
of clinician scientists, will be targeted to CADs. CADs will be developed for cancer, transplantation, women’s
health and cardiovascular diseases. Other CADs may be considered, and academic programmes will be
developed in Clinical Directorates that in time may evolve into CADs.
At the end of June IEHG launched its first Cancer Academic Directorate; this cancer clinical academic directorate
(CaCAD) provides for convergence of the considerable expertise of the two cancer centres located in SVUH and
MMUH into a single function operating across two sites which will also embrace cancer services delivered in
other group hospitals. The critical mass created by the convergence will allow us to be at the forefront in
providing preventative care, cancer genetics and adolescent cancer services and will enable the Group to
respond positively to the new cancer strategy when published. This is a significant clinical service reorganisation
and remodelling initiative which reflects the value of hospital groups as provided for in government policy.
The key focus of the Clinical Academic Directorate in Cancer is the strategic alignment of research, health
education and patient care, to deliver the best care and treatment for patients, advance cancer research and
create the ideal training environment for all.
Health informatics / digital health
A key priority for the Group is to develop IT and data analytics capacity. Currently hospitals within IEHG have
varying levels of technology underpinning their clinical services, with the HSE hospitals having very limited IT
functionality. By introducing common platforms, we can support integrated pathways of care for our patients
throughout the Group. This will align with the HSE’s e-Health strategy. The development of data analytics will
transform our decision making process, so that we have real time information to inform our approach to clinical
service design and delivery.
This programme builds on a major area of expertise and investment within UCD, which has established
INSIGHT, the national data analytics centre and the Applied Research for Connected Health. . Similar centres
have been established in the UK under the Farr Institute umbrella funded by the NHS and major funding
agencies, including the MRC and Wellcome Trust. The objective is to provide ‘safe havens’ for the data
generated by the health service and to develop tools to analyse these data. The Health Informatics/Digital Health
programme will be led by a Director responsible for the development and deployment of IT, data capture and
data analytics, with a joint hospital and university appointment, including a Principle Investigator appointment to
INSIGHT.
Page | 15
Genetics / genomics
The exponential development of technology for sequencing and interpreting human genomics and genetics is
having a major impact on the diagnosis and treatment of disease, particularly in cancer, cardiology, neurology
and rare diseases. The requirements of the clinical genetics service are also changing, with a greater emphasis
of care provided within specific specialties. UCD and the IEHG have already put in place a genetics and
genomics service, with the university establishing a Next Generation Sequencing Laboratory equipped with
sequencers capable of whole exome and whole genome sequencing, while the hospitals have developed closeto-care facilities that provide sequencing of gene panels and expert clinical care. UCD is well placed to develop
the service with the hospitals, with specific strengths in bioinformatics and systems medicine, while the clinical
service has specific clinical expertise. In the next 3 years, the service will be further integrated, with a Director
appointed to oversee the development and delivery of the programme across the entire IEHG, as well as
providing specific services nationally. We will explore partnerships with large-scale providers of NGS, and have
initiated discussions with an industry provider and with the University of Edinburgh. A key objective is the
establishment of training programmes relevant to clinical genetics. Towards this goal, the university has
established an MSc in Clinical Bioinformatics in the School of Medicine, which will be anchored in the clinical
genetics programme.
Human imaging
Human imaging technology is rapidly developing and is key to several IEHG priority areas, including cancer and
neurosciences. A particular focus in the next 3 years will be the development of the PET/CT service and the
radiopharmaceuticals required. To this end, a UCD/IEHG Research PET/CT centre is being established in SVUH
and is likely to be in place by the end of 2016. In addition, plans are being developed for a Radiopharmaceuticals
Production Facility to be developed alongside the PET/CT centre in SVUH. The technology includes a cyclotron,
synthetics radiochemistry and GMP facility. UCD has committed to appoint a senior radiochemist jointly with the
IEHG to lead the Facility and is in negotiations with potential providers of the technology.
Education and training
Key to the success in achieving the strategic objectives of the Ireland East Hospital Group (IEHG) will be the
recruitment, retention and recognition of world-class healthcare and professional staff and the development and
recognition of existing staff across the eleven partner hospitals and community health organisations.
The Group structure will enable the development of post graduate training rotations particularly between the
model 3 and 4 hospitals. It will also enable rotation between St. Vincent’s and Mater in key specialities. Our aim
is to introduce post graduate fellowship programmes within our national specialities.
The IEHG offers placements for up to 1000 undergraduate students at any one time and within health sciences,
some 2500 students are enrolled in postgraduate diplomas, Masters and PhD/MD programmes.
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We propose to develop an IEHG Academy for Healthcare Education and Training, where there will be a strong
emphasis across all of the disciplines on





interdisciplinary professional training
workplace skills
emerging technology
experiential learning
internationalisation
To support this approach we are developing a model for the group which will see the development of academic
centres in the Level 3 Hospitals which will connect to the larger academic centres of Mater and St. Vincent’s.
In addition, we are developing programmes that focus on general practice and primary care, recognising that
50% of our graduates that continue in clinical practice go into community health. We are providing placements
for students in general practice early in their medical curriculum and will develop internships in general practice,
initially for a small number of graduates.
In addition to preparing undergraduate students for careers in health care or health related fields, UCD offers a
wide variety of internationally recognised postgraduate courses and degrees that enable all professionals further
their education. Areas include health professional programmes, management, science, data analytics and health
promotion or other related programmes. UCD provides opportunities through our research and innovation
programmes across the colleges and institutes opportunities for research degrees, including MRes, MD and
PhD. The IEHG and UCD will support staff in particular through the development of specific programmes critical
to its mission of better patient care, including programmes in leadership and development, quality and patient
safety and emerging technologies.
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